Impact Series

How the Gates Basis and Seattle nonprofit PATH are serving to get oxygen to India

PATH coordinated with vendors to install pressure swing adsorption oxygen generation plants at medical facilities in India. (Photo courtesy of PATH)

The Bill & Melinda Gates Foundation has teamed with two Chicago financial groups to channel $5.5 million into efforts by Seattle-based nonprofit PATH to bring more oxygen to COVID-19 patients in India.

“Lack of access to medical oxygen is one of the defining health challenges of our age,” said Chris Elias, president of global development at the Gates Foundation. “As we are now seeing in India, the consequences can be dire.”

PATH is working with officials in 10 Indian states to help identify sources of oxygen for hospitals. PATH teams also are helping agencies identify how much oxygen local hospitals have on hand, and how much they’re going to need.

India is being overwhelmed by a second-wave COVID crisis that is killing more than 4,000 people a day.

The official death toll was 262,000 as of Thursday, according to Johns Hopkins University. But the Institute for Health Metrics and Evaluation at the University of Washington has warned that the actual number of deaths is probably three times that. IHME projects total COVID deaths in India will top 1 million by Aug. 1.

Lack of medical oxygen in hospitals is compounding the crisis in India. Hospitals in many areas report running low or even completely out of oxygen on a regular basis. So many people are dying that cemeteries and crematoriums in some areas can’t keep up.

The problem is that COVID patients require far more oxygen than hospitals would use on a patient with another disease, said Mohammed Ameel, PATH’s head of primary healthcare, technology and innovations in New Delhi. Oxygen is particularly important to seriously ill COVID patients, who usually develop pneumonia.

About 15% of COVID patients in India require oxygen, Ameel said. According to one report, major Indian hospitals are now using as much oxygen each day as they normally would in a week.

Under typical circumstances, India produces more than enough oxygen to meet its medical and industrial needs, Ameel said. But as demand has increased, the country’s supply chain has broken down. Large rail tankers that bring liquid oxygen to major hospitals used to travel 200 kilometers from production site to delivery point; now they’re traveling 1,000 kilometers to bring emergency oxygen to new customers, he said.

“The challenge is supply chain and turnaround time,” Ameel said.

And not all hospitals have the capacity to handle the huge oxygen tanks, Ameel said. “The challenge is not only in production, but if you produce enough, how do you transport that, and when you get to the hospital, where do you store that?” he said. “(In many cases) you don’t have the capacity to do that.”

PATH has been working closely with officials in the states of Punjab, Maharashtra and Karnataka to help them address those issues. Karnataka’s capital is the tech center of Bengaluru, also known as Bangalore; Maharashtra’s capital is Mumbai, the nation’s financial center. “We’re supporting procurement,” Ameel said. “We’re helping them securing oxygen concentrators and oxygen generator plants.”

Building new oxygen generator plants closer to hospitals cuts down logistical problems. And oxygen concentrators — small, bedside units that pull in air, remove the nitrogen, carbon dioxide and other gases — can provide oxygen for a handful of patients. Oxygen concentrators are particularly helpful in areas where hospitals are full, Ameel said, because patients can be sent home with one.

Donations like the one from the Gates Foundation have been pouring in in response to the crisis in India, said Carla Sandine, PATH’s chief of external affairs.

“We are seeing an outpouring of support across the United States for the global COVID crisis,” she said. “That includes the U.S. government and it includes U.S. companies.”

Last year, donors were focused on giving to domestic COVID relief efforts, she said. But now “I feel a shift,” Sandine said. “In the U.S., people are feeling relieved about what’s starting to happen here and horrified that much of the world has no end in sight.”

And, she noted, in places like Seattle, “the Indian diaspora is large and engaged and charitable and beloved.”

Last week Seattle-area tech leaders formed a group called Seattle for India that’s trying to raise $10 million to support efforts that are delivering crucial healthcare supplies to India. Hometown tech giant Microsoft is also lending a hand, using its technology and donations to help the cause.

PATH is using donations in two primary ways, Sandine said: providing funding to deploy teams and resources to India and adjacent countries to scale up oxygen production, and to help fund development and testing of a new low-cost COVID vaccine that could be manufactured in many places worldwide.

The Gates Foundation teamed with Chicago-based Citadel, an investment management firm, and Citadel Securities, a finance company, to make the donation. It’s the first announced grant since Bill and Melinda Gates announced plans to divorce on May 4.

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